One to One Community Care

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through organisation and delivery.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.Staff were familiar with people's individual routines and likes and dislikes. They were aware of the importance of providing person centred care and offering people a choice in relation to how they chose to live their lives. However, care plans did not contain enough information to allow new staff to get to know people well or to deliver person-centred support. Care plans often failed to capture people’s views and opinions or identify how people wanted to be supported.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. We saw examples where support hours had been adjusted to meet individual needs including when people were discharged from hospital. One person told us, “I have been with the service a long time and can request extra if I have been in hospital.”.

The provider supplied appropriate information in formats that were tailored to individual needs. Information was given to people when they first started using the service. Staff could give us examples of how they tailored communication to meet peoples unique and diverse needs. One staff member commented, “We use clear communication with all the individuals we care for. We observe and listen, recording and reporting any concerns we have about the individual’s ability to communicate. We then take the appropriate action to ensure clear communication is maintained. This may involve the use of communication aids or medical consultation.” Staff were trained to understand the importance of maintaining confidentiality.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care. Although formal feedback had not been recently collected and analysed, people and their relatives overall told us that they were happy with the service and their family member knew how to complain if they needed to. One relative told us, “Any problems I just tell [Name of Registered Manager]. [Person] is proactive, has visited at home and even does some of the care at times.” The provider assured us that plans were in place to reinstate formal feedback from people and relatives.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People were seen to be treated fairly and equitably. Staff were responsive to people and supported people to access services in a timely way. Records of support provided showed people were supported with healthcare and when additional unplanned support was needed the provider was responsive and provided this including out of hours. One relative told us, “The service will always respond to any change of circumstances.”

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Staff spoken with as part of the assessment knew people well and how they liked to receive their care. They understood that people had a right to be treated equally and fairly. However, people’s care records did not always contain information about their wishes in relation to how their social, cultural, and spiritual needs should be met. This meant any new staff did not have access to information about how people should be supported with these specific needs. The provider had policies and procedures in place relating to equality and diversity, but these had not been personalised to reflect the service. Records did not show that staff had received training in Equality and Diversity. Overall people and their relatives felt they were treated as individuals and their views sought and listened to.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.The provider completed care reviews with people and their families to ensure people’s care continued to meet their needs. However, information from these reviews did not always transfer into care records. Information around future planning including where people had advanced decisions in place was often not clear. One person had a comment in their care record relating to a decision of DNARCPR (Do Not Attempt Cardiopulmonary Resuscitation) but no form was present or details of what end of life decisions had been made to guide staff or health care professionals in an emergency.